For Employers: Plan Forms and Documents

Looking for forms and documents? Here you'll find forms to complete enrollment, make payments and much more. We also have information to help employers, employees and agents make important decisions.

Still have questions? Contact Us

Choosing coverage

Overview of Group Blue Cross Coverage (PDF)

Use this guide to find and understand important information about your group coverage with Blue Cross Blue Shield of Michigan or Blue Care Network.

Blue Elect Plus℠ POS and Blue Elect Plus HSA℠ POS decision maker brochure (PDF)

Find value, flexibility and more choices with Blue Elect Plus.

Healthy Blue Living℠ (PDF)

Healthy Blue Living is a wellness incentive plan. This plan rewards members with cost savings for learning more about their health and taking action to improve it.

Healthy Blue Living flyer for employers (PDF)

Help your employees learn how they can save on premiums and be proactive about their care.

Blue Care Network HSA Employer Guide (PDF)

Blue Care Network HSA health plans are smart, practical solutions to cover your employees at a cost that fits your budget while still providing unmatched value.

Enrollment forms

New Enrollment and Change of Status form (PDF)

These conditions and instructions will help employees enroll in a new plan or change to a different one.

New Enrollment and Change of Status form in Spanish (PDF)

If you're enrolling a Spanish-speaking member, this is the form you'll need to enroll them in a new plan or change an existing one.

Employee Waiver form (PDF)

If an employee wants to waive coverage, they'll need to read and fill out this form.

Employer Waiver form in Spanish (PDF)

If you have a Spanish-speaking employee who wants to waive their coverage, have them return this form.

Managing my account

Blue Care Network Self Funded Group Exception Form (PDF)

This form is for Self-Funded ERISA and Self-Funded non-ERISA groups to fill out for payment exceptions.

Healthy Blue Living group administrative manual (PDF)

This reference guide provides valuable information to help you administer Healthy Blue Living and answer questions your employees may have.

Blue Cross Blue Shield of Michigan and Blue Care Network Consolidated Appropriations Act Gag Clause Prohibition Compliance Certification (PDF)

This compliance confirmation is a detailed description of the requirements for health insurance issuers. Read more to find out the importance of compliance and what is required.